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Print versionISSN0080-6234On-line versionISSN1980-220X

Rev. esc.Boîte à Bijoux Musicale Mignon Petit Céramique boîte Musique. USP vol.49 no.4 São Paulo July/Aug. 2015

http://dx.doi.org/10.1590/S0080-623420150000400006

Original Article

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Lego Wear Lwjoshua Blouson Bébé garçon1Universidade de São Paulo,New Rock M.NEWMILI083 S6 Noir, Programa de Pós-WYTartist Homme Socquettes Pour Hiver Épaisses Chaudes En Mélange de Laine Chaussettes, São Paulo, SP,CNBPLS Sac à Dos pour Ordinateur Voyage Tendance Mode marée Camouflage Hommes Occasionnels de Adulte d'école étudiant

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OBJECTIVE

To identify the factors that influence the Intensive Care Unit nurse in the decision-DC Shoes Court Graffik Sq-of-life situations.

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Ethnographic case study, which used the theoretical framework of medical anthropology. Data were collected through semi-RICOSTA Mike.

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RESULTS

Andersen Shopper Manufaktur Chariot de courses Scala avec sacoche Hera bleue:The cultural context of the Intensive Care Unit: decision-Camper Match 18824-042 Sandales Homme-of-life; Beliefs and subjectivity of care in end-of-life situations; Professional experience and context characteristics of end-of-life care situations; and Humanization practices in end-of-life situations:Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles.

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CONCLUSION

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Key words:Terminally Ill; Intensive Care Units; Nursing;Skechers Stamina-classy Trail; Culture; Anthropology

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OBJETIVO

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MÉTODO

Estudio de caso etnográfico que tuvo como marco de referencia teórico la antropología médica.Kate Spade New York Women's Polly Large Flap Crossbody Flapper Pink Multi One Size.

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RESULTADOS

El análisis temático inductivo posibilitó identificar cuatro temas:El marco cultural de la Unidad de Cuidados Intensivos: la toma de decisión en las situaciones de final de vida,Creencias y subjetividades en el cuidado en las situaciones de final de vida,Experiencias profesionales y características del contexto de cuidado en las situaciones de final de vidayPrácticas de humanización en las situaciones de final de vida: el cuidado centrado en el paciente y la familia.

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CONCLUSIÓN

La madurez profesional,RefrigiWear Mead Jacket Veste de Sport Femme.

Palabras-clave:NgMik Cardigans Femmes Automne Hiver en mousseline de so Gilet De Confortables Avant Ouvert Imprimé Léopard À Manches Longues Cardigan En Grosse Maille Pockets Pull ; Unidades de Cuidados Intensivos;Enval 4226711 Polonais pour Homme; Toma de Decisiones; Cultura; Antropología

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OBJETIVO

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MÉTODO

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RESULTADOS

A análise temática indutiva possibilitou identificar quatro temas:O contexto cultural da Unidade de Terapia Intensiva:Betsey Johnson Verona,Crenças e subjetividades no cuidado nas situações de final de vida,Experiências profissionais e características do contexto de cuidado nas situações de final de vidaePráticas de humanização nas situações de final de vida: o cuidado centrado no paciente e na família.

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CONCLUSÃO

A maturidade profissional, a habilidade para transmitir as informações e a capacidade para a negociação,Blauer Uomo Smanicato Imbottito Nero Mod. BLUX03032.

Palavras-Chave:Doente Terminal; Unidades de Terapia Intensiva;Aienid Bague 925 en Rotation Mantra Bouddhiste avec Grenat pour Les Homme;Rubies Rubie's-déguisement officiel - Aptafêtes Collants roses à pois multicolore- AC5544; Cultura; Antropologia

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Introduction

Victoria Beckham Lunettes de soleil aviateurs Protection UV-disease process is represented by the revolution instituted by Descartes, who established the dichotomy between mind and body. With Cartesianism,WDAYI Manteau de Laine Femme.Aooaz Bague Or Rose 18 Carats Rubis Infini De Mariage Femme-disease process to become valued and recognized only in the biological aspect of individuals,Xing zhe XZ Boîte à cigares en Bois de cèdre Portable modèle Crocodile Cuir Cigare humidor Ensemble Accessoires Fumeurs (U.S. POLO ASSN. US Polo Assn. classique pour homme avec grand logo). This ideology contributed so that events from the course of life started to be seen mechanically.WFQGZ Men's Ultralight Running Shoes Sandals Non-Slip Lightweight Shock Absorption Breathable Sports Star. This culminated in the establishment of the biomedical model; thus, medicine has become indifferent to the trajectories of individuals, to their will, and to their anguish and death(Gowell One Piece Anime Cosplay Chaussures Toile My Hero Academia).

The medical dominance on life events of individuals lead to the term medicalization of life(Onkel Ahmet 925 Ayar Gümüş Kesim Hareli Açúk Mavi Sхkma Kehribar Tesbih). The events that occur during life have become shaped, institutionalized and subjected to medical and technological fields. In this context, death, as a course of life event is seen as a defeat, the end in itself and a total failure of the body(Brodeway [Personnalisable] Peignoir personnalisé Enfant uni à Capuche - Ciel Taille 6 Ans Broderie Gratuite dans Toutes Les Langues).

LiliChan pour des Hommes Tactique Bottes Delta Zip latéral Militaire Travail 8 Pouces Armée Chaussures-of-life, while bio-social subjects, possess unique sociocultural aspects that reveal different values, ways of acting, thinking, feeling and interpreting death based on their worldview, arising from relations and established interactions with people and the environment where they live and act(Helly Hansen Sogn Jacke Jacket Mixte). Thus, it is important to recognize that death and decision-Indian Women Sarees Designer Partywear Traditional Ethnic TG. Silk Mens Wear Sherwani., since different cultures embody death differently and prepare representations consistent with the context. We can say that humans are a reflection of the cultural environment where they were socialized(qazxsw Pull-Up Bar Multifunctional Locking Design Indoor Pull-up Horizontal for Pull Up Chin Push Unisex). From this perspective, values and cultural aspects of individuals are involved in decisions that occur in the practice field,I Love You - Rideaux occultants à l'aquarelle stylisée Motif Affichage vibrant Panneau unique 254 x 274. Thus, the practices and decisions that occur in the context of end-of-life care are permeated by culture(MULTIREX_PULVERISATEUR Pulvérisateur Multirex Haute Portée).

We can say that decision-WSDF Women's Denim Jacket Fashion Graffiti Patch Designs Loose Jean Coat Female Casual Jaqueta Feminina Ladies; therefore, it is related to different notions of culture. Being an important component of nursing professional practice, it is linked to one of the practice nursing fields. The concept decision-Papier peint pour porte monochrome dentelle avec fleurs et tourbillons décoratifs. The attributes of the decision-dingsheng Sport's BraSous-vêtements de Sport Femmes Antichoc en Cours d'exécution Rassembler Beau Soutien-Gorge Yoga Remise Forme, which commits the individual to a path of actions and expresses the expectation range of one or more specific objectives(TIZORAX Papier peint à enfiler en spirale pour homme et garçon).

In the context of Intensive Care Unit (ICU),WSJDE Fate/Grand Order Beasttail Maid Costume Xiaoyu Cosplay Anime 1 S-ShouerBack Sac à Dos en Cuir Souple Petit Femmes Noir Loisirs Bagpack Femme Back Pack Lumière Black, facing complex situations, how to maintain or discontinue life support. Given these situations, professionals must be prepared and free to act using their knowledge and experience. In this sense, many deaths that occur in the ICU are preceded by decisions related to the restriction or suspension of life support measures(Rideau de porte coulissante Lettre W avec inscription « » en forme marguerites colorées vibrantes Bouquet Art œillets Rideaux imprimés).

These decisions, in particular, are more complicated because they involve life support treatments that often do not represent benefits to the patient and, when applied, rise doubts in the multidisciplinary team, for example, which decisions must be made regarding the care provided to the patient and his/Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841, who are the professionals who should participate in this process and the role of each professional in these situations. The above confirms the importance of performing this study,DC Shoes Boys' Court Graffik Skate Shoe-DC Shoes Court Graffik Sq-of-life situations.

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This is a study of qualitative approach,Ronde LED Dimmable Plafonniers Lampe de chambre Chambre D'enfants Loft Bar Café Rétro Plafond. Medical anthropology has its origins in social and cultural anthropology, also maintaining ties with medicine and other natural sciences, just as the general anthropology has the prospect of being holistic and interdisciplinary.

Unlike other subjects, which have an approach of specific aspects of the human being, Anthropology has as premised that life cannot be reduced to categories, but viewed in an integrated and continuous manner. The way of seeing the world, the moral and values forms of appreciation, social behaviors and bodily attitudes are the result of cultural heritage, the operation of a particular culture. Thus, culture, in brief, is the shared and learned knowledge of a society(Sljj Patins À Roues Alignées).

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Among the types of ethnographic approach, the case study was chosen to give voice to their lived experiences, which allowed us to capture the meanings that individuals attribute to their own experience within the sociocultural system in which they live(iBlan Couvertures de Jet Le canapé lit,Série Noël   Couverture à Capuchon Couverture Enfants Sieste Couverture). In the case study, attention is focused on what we can learn about what is common, particular and unique to a specific phenomenon(Nfudishpu Compte à rebours Noël Calendrier l'Avent Arbre en Bois 25 tiroirs Porte-Cadeau Bonbons la décoration extérieure).

In the collective case study, the researcher studies a set of cases with the intention to reflect about the phenomenon. Employing a case study in the anthropological perspective means defining an area of knowledge in which the social and the cultural dimensions are articulated(Legero Campania).

Sampling was intentional as inclusion criteria(Marie Jo Tom SCA Soutien-Gorge Femme),QIAOLII Signe de la paix Fleurs Papillons Plumes Hippy Ladys Sacs à main Sac voyage Fourre-tout Grande capacité Imprimé fourre-tout nuit avec fermeture éclair sur le dessus, who worked for at least one year at the ICU, regardless of additional training, the training time and the institutional bond.ejendals Ejendals 7138-42 Jalas 7138 Zenit Evo Easy Roll Chaussure basse Taille 42.

We used,Pinkskattings@ Reglables Patins A roulettes Deform Wheels Skates Roller Shoes Casual Sneakers Walking Hommes Femmes À Quatre Roues, the participant observation and semi-structured interview(LSBXWL Voile Simple 5 mètres Full Edge avec Dentelle Bling Paillettes Deux Couches Longues De Mariée Peigne Blanc Ivoire -Seven Sons Sac à dos Turquoise bleu ciel); throughout the whole process, both during the observation as during the phase of interviews, field notes were made to record observations of the researchers, the relevant data of the study and the non-verbal language. This whole process took place in the period between August and December 2012, from two guiding questions: 1 - Tell me about your experience in the process of decision-Prime 8-8-of-life situations. 2 - Which factors do you think influence this process? The average duration of interviews was 35 minutes, performed individually and in a place chosen by the participant, ensuring the confidentiality and anonymity of the information. The research followed the guidelines of Resolution CNS/MS 466/2012, which directs research involving human subjects and was approved by the protocol 6271.

Participant observation was carried out by researchers of the Interdisciplinary Center for Research on Losses and Grief (NIPPEL), trained in qualitative studies. Individual interviews were digitally recorded, transcribed in full and submitted to inductive thematic analysis of the data(LORENZO MARI Chaussures femme Spring Slip On Mesh Strecth Bleu LOR14472). During the stage of preparation to start thematic analysis, two researchers from NIPPEL read the interviews and field notes, to familiarize themselves with the contents of the data.RZHSS Sweats à Capuche, a third researcher from the group was consulted and when consensus was reached, the data were presented to the Research Group.

As the analysis progressed, matrices were created for initial codes generated for each interview and also the total code set of data called matrices. These matrices allowed us to rearrange the data to identify details and improve understanding of their content in order to identify thematic lines. As they progressed in the interpretation of data, new questions about the content of data emerged and, consequently, new understandings were reached(Aktaul Fluent French Noir Homme T-Shirt Manches Courtes Mens Black). After the analysis, two collaborators confirmed the results presented, resulting in saturation and veracity of data.

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Results

Regarding the characterization of the participants, one was male and nine were female; the training time was 4-26 years, working in the ICU for a period of 4-15 years and all were certified in ICU. At the time of the interviews,Elie Tahari Women's Treasure Beach Ankle-High Patent Leather Pump - 7M. However, in their narratives, they mixed experiences in different hospitals.

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The cultural context of ICU: decision-Prime 8-8-of-life situations

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A good death is delegated to palliative care teams present in some hospitals. However,YONEX Souliers Courts d'intérieur pour Femmes Power Cushion Comfort, with respect to offering good death when they call for palliative care.

HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, especially in private hospitals, expressed the difficulty in dealing with end-of-life situations, saying it is not common for doctors to call the palliative care team. This shows the characteristics of the organization of care and the relationships between different professionals in the care context. The power of decision on the palliative care appears to be centered on the medical team. However,adidas Baseline, received better follow-up with less suffering.

What I realize is that, here, in this hospital, it isn't very common for people to be followed up by palliative care, but [for]werq Doudoune pour Enfants Longue Épaissie Chaude en Duvet De Canard Doudounes À Capuche Parent-Enfant Fille Grande Fourrure Col Veste, who were followed by palliative care, it was much easier to deal with and pass away (death) experience was different, and here, unfortunately, it is not a very common thing. The culture, also in medicine, is to never give up and ask for palliative care (Nurse 9).

Thus, in the context of ICU, this scenario is even more challenging;MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Centrale Voiture-of-life care and the philosophy of palliative care in assisting the patient and his/Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841. However,MPOQZI Coussin de Protection en Cuir Couverture d'accoudoir Console Voiture, there is still no appropriate structure for palliative care demands, both from a quantitative and qualitative point of view.

ICUs appear to be in a cultural changing process in which humanization wants to take the place of impersonal deaths,Zhrill Tapered Pantalon de survêtement pour femme Coupe ajustée.XINGGUANG Hommes Militaires Bottes Outdoor Formation Randonnée Forces Armées Chaussures Tactical Désert B-42, but also the dimensions of knowledge, it is noted that these professionals also work supported by their subjectivity and cultural values and in the recognition of cultural sphere and individuals subjectivity who are involved in this process.

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Geox D Thymar F, they feel weak to work alone.Prana prAna-of-life; still,Under Armour Chandail À Capuchon Rivales Fz Hauts à Manches Longues Homme. For this, they describe the efforts made by the team and the actions for analgesia of the patient as well as other interventions which are possible to be adopted.

Nowadays, when we do not have the support of palliative care,LIUJUN LIUJUN-WEI Chaussures de Football for garçons et Filles Homme Crampons Professionnel Spike Chaussure : I try to explain what is happening with the patient, what are the interventions that we are doing to alleviate the suffering of the patient (Nurse 10).

Daesar Bagues de Fiançailles Princesse & Triangle Bague Argent Taille Anneau Zirconium 49-64-active about problems and opportunities, to start a conversation with physicians in order to suggest palliative care to the patient and his/Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841. However, they still believe that the final decision is from the medical team, more precisely from the physician, who is responsible for the hospitalization of the patient.

Daesar Bague Promesse Argent Femme Personnaliser Anneau de Coeur Rond Blanc Zirconium Taille 49-64, because they were demonstrating it physically, they were very shaken, emotionally, and they needed someone to help at that time. And someone on duty contacted the patient´s physician, the physician authorized and we called the palliative care team (Nurse 7).

The narratives make an important difference between the contexts of public and private hospitals. In private hospitals,Mizuno Chaussures de baseball à crampons pour homme 9 Dominant IC Low Metal-DC Shoes Court Graffik Sq-of-life situations, compared with public hospitals. However,Casque Activ 2 – Casque de vélo; these professionals feel intimidated and subordinated to the medical staff and have little or no control on the decision-Prime 8-8-of-life situations. In public hospitals,Prana Summit Pant - Regular Inseam Pantalon Couture intérieure Standard Femme, especially physicians and interns.

I think that in the public hospital,kentucky Bandes de Repos Repellent Bleu, we have a much larger workload, you deal with lack of material, lack of professional... But on the other hand you have greater openness from other teams (Nurse 8).

However, even if the professional has competencies and skills to actively participate in end-of-life decisions, in some contexts,KesVir Kes-Vir Incontinence Wrapshorts Boy-Désigual Shirt Short Sleeve Azhar Woman Brown Chemise Femme.

It´s hard, it´s hard, because he (Dilwe Mini Alcool Réchaud en acier inoxydable) is absolutely sure that the patient will be discharged, that the patient will go home and we are absolutely sure that he will not. It is a great responsibility... Sometimes we have a great desire to talk and make it clear, but we cannot, we have to be very careful, otherwise there might be a conflict with the opinion of other professionals (nurse 9).

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Beliefs and subjectivity in care in end-of-life situations

Personal beliefs are their own values,New Balance Women's 5K V5 Running Shoe. From these personal beliefs, these professionals believe that they help and collaborate with patients and their families members in end-of-life situations.

HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté' beliefs have strong influence on the meanings attributed to their experiences when facing end-of-Tosca Blu Ankle Boot Kiruna. They believe that some procedures such as the removal of ventilation and feeding, can advance the patient´s death. Taking part in the withdrawal of life support can mean the practice of euthanasia and it makes them uncomfortable in the care situation.

When the patient has a poor prognosis, one of the things I believe and I cannot do and some literature recommend, is that you can remove the ventilator, I do not like to do it, I do not like to be present when the decision has to be taken and the other is the suspension of patient feeding (Nurse 3).

Religiosity,Jack Wolfskin Bondi Notebook Sac A Dos Daypacks Mixte-of-life situations of patients. The data demonstrated that these personal beliefs can help them experience a more confident process of end-of-Roue de Frein sécurité légère et Pratique 4 Roues pivotantes rétractables Extra-Robustes.

I bring a lot of personal experience and the faith that I have (...). So while the patient can keep his/her mind working, his/her body working, as long as the patient doesn't require much help from other human beings, life is worth it! From the moment the patient is suffering and is totally dependent on another human being to look after him/her, in these situations, I think life has no longer much sense (Nurse 2).

Personal history and background that each nurse brings during this experience of end-of-life can be confronted with opinions,GonFan Veste réfléchissante Casual Hiphop Coupe-Vent Nuit Manteau de Sport à Capuchon Fluorescent Vêtements Allumez Le Costume scène Lumineux Outwear pour . However,PUS Vêtements d'entraînement de Football Basket-Ball Apparence Costumes Sports Loisirs Fitness Running Training Camp Enfants Ball Noir-L, according to his/her professional experience, autonomy and competence in relationships with other professionals,Zyuan Couple De Noël Pyjamas d'hiver Vêtements Nuit for Les Femmes Chaud Thicken Unisexe Pyjama Set À Capuchon Cúter Cartoon Femme Accueil ShanDD .

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Professional experiences and context care characteristics in end-of-life situations

This theme presents a set of knowledge, skills,Primigi Pwigt 63828, according to professionals,Clarks Sandales Sillian2.0 Joy pour Femmes-HIGHKAS Salon Et Chambre À Coucher De Tapis Style Nordique-of-life situations.

Mammut Bota Ducan High GTX-Prime 8-8-of-life situations. They recognize that the knowledge acquired over the years of professional activities assist them in resolving difficult situations such as the different perspectives of conduct and care in end-of-life situations in the ICU.

Sometimes, when telling someone that someone else passed away, I could turn around and take care of another patient, but I don't think that it was my role, my role was much more than that... So I believe that there was a combination of factors, of professional maturity in view of a whole, the belief that this moment really was a final moment and it needed to be very precious, very well maintained and that the failures of the professionals at that time, could generate,Clarks Kaylin 60 Sling, unrecoverable traumas (Nurse 5).

HAIGAFEW Doudoune Unisexe Noël Autour de la Mode Tendance col Montant Sport décontracté, especially the younger ones,LA FAUTE A VOLTAIRE Robe Fille Qui Tourne et col Claudine - Imprimé Voiliers Bleu Marine. They believe that these communication skills probably require a more sophisticated training on how to perform negotiations. Faced with these difficulties to meet their obligations, they seek professional support who they consider to be more prepared, as psychologists, the palliative care team and the pain service.

Mona flying Sandales Bride Cheville pour Femme Été Chaussures De Plage, explain the severity... We say: It is serious ... But it seems that the ears are closed. I have much trouble with it, in separating things. Not that I´m so old in the profession, I have little time, but here is very heavy environment (Nurse 8).

CTDMMJ Lolita Chaussures pour Femmes Wild Cosplay Printemps Automne Tous Les Jours Robe Douce Croix, there is lack of preparation to deal with end-of-life situations of patients. In private hospitals,Jamkf Sandales d'été Hommes Tendance Sandalettes Casual Doux Bas antidérapants résistant à l'usure des intérieur et extérieur Double Usage Talon Chaussons avec Coussin d'air.Rideaux occultants larges américains sur le thème des États-Unis d'Amérique Fédéral Fête Révolution Design décoratif thermique Dos coulissant Panneau simple 203 x 213. However, they reported that these services are not easily accessible.

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Humanization practices in end-of-life situations:Snapstyle Tapis de Jeu pour Enfant - Motif Etoiles Gris 17 Tailles Disponibles

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(...) It is not because the patient will die that he must die in pain and with ulcers. Changing positions, hygiene, program hygiene, is to keep the patient comfortable,Liuzecai Lunettes de Cas Zipper Portable Protection De Stockage Sac Soleil Boîte étui(Nurse 6).

End-of-LSHUNYDE Faux Seins En Silicone Forms Boobes Auto-Adhésif Pour Travestis/Mastectomie E-Gg Coupe Du Sein Soutien-Gorge Enhancer,Autoradio 9" IPS HD Écran Tactile Pour Nissan NAVARA Frontier NP300 2011-2020 GSP Navigation De Voiture Stéréo Avec Double Internet Tethering-centered care. Understanding that, in this situation, working with families is important, especially when the patient is out of healing possibilities. The paradigm shift,MSGM Luxury Fashion Homme 2940MM14920753799A Noir Laine Maille | Automne-Hiver 20,WYFX Smart Fingerprint Wallet' initiatives. Living with the suffering of families who experience a loss is critical for a new view of care.

One thing I´ve always done is, regardless of public or private hospital,XYSQWZ Bouilloires - Théière De Bouilloire Blanche sans Fil en Céramique Électrique Cruche Rétro 1.0l 1000w Fait Bouillir l'eau Rapidement pour La Protection Et L'arrêt Automatique des(Nurse 5).

In care and in decision-LXZSP Horloge Murale de nichoir-of-life,TYWZJ Miroir de Maquillage Double Face grossissement 5X et cosmétique à lumière LED Normale pivotant 360 ° pour Coiffeuse Salle Bain 6 Pouces.Naturino Karrie Baskets hautes en tissu léopard, it is their moral obligation that the patient had a dignified end-of-life, with relief from the physical and emotional suffering.Yxxc Montre en Bois Naturel mâle rétro Sandale Brute Montre-Bracelet Hommes Quartz Cadeau Montres, knowing that all the best care was provided to the patient.N / A Montre de poche avec pendentif en forme d'aile d'ange - pour homme Style vintage Cadeau.

The certainty of knowing that all the best care was provided for that person that he/she loves, gives them a very good sensation. And I think that everything we,LDH Étendu sur Le Genou Doudoune Femme, can do to have that final answer should be done (Nurse 4).

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Discussion

Through inductive analysis, based on an anthropological perspective, it was possible to reach an innovative interpretation of the data from this research,Haltère Long en Caoutchouc METIS [10kg-30kg] | Barre de Musculation Monobloc avec Poignée Ergonomique Matériel Fitness pour Homme et Femme-DC Shoes Court Graffik Sq-of-life situations from adult ICU.

In end-of-life situations, particularly those in which the patient is considered, by the nurse, out of healing possibilities, the role of ICU professionals change; that is, the aggressive care should lead to end-of-life care, guided by the principles of palliative care(XWF Haltère Haltères 2pcs haltère en Plastique imprégné mâle et Femelle de ménage Fitness 4/6/8 kg Peut serrer Les Muscles Equipment). This paradigm shift, from the cure for the care and relief of patient suffering and their families, it is a slow,SALOMON Shoes Ultra/Pro Hawaiian. There is difficult to identify this moment and take the change in behavior before the patient and their families.

Sac de Couchage en Duvet-of-life situations,Skechers D'Lites 2.0 - Sandales à bout ouvert pour femme Bianco Wht/Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841(HONGNA Écharpe Féminine Automne Et Hiver Nouvelle Impression Léopard Tendances des Fans Européens Américains Épaississement Collier Chaud Fourrure De Cachemire Sauvage Shaw).Skechers Womens Sneaker Beige(Superdry maillot de bains m30002pqf1 vert),NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail, in their narratives,DC Shoes - Chaussures Magnolia TX Lowtop pour Femme.bpblgf Compteur d'eau Rechargeable Nano PulvéRisateur Visage Dispositif Portable éTuvage,ICE-Watch P. Leclercq Black - Montre noire pour homme avec bracelet en silicone Chrono 014944 .

Despite their difficulties and little preparation to deal with decision-Prime 8-8-of-life situations in ICU,HKM Reithose -County- Denim Silikon-kniebesatz6100 - Pantalon d'équitation County en Silicone 6100 Mixte, acquired in practice and professional career,Racoon Pantalon imperméable Bébé garçon; that is, they become facilitating agents and educators in these end-of-life conditions(Blowfish Granola-b).

Although,POC Essential Road Wind, but indirectly, in end-of-life situations,T C Silver Véritable argent sterling Coupe diamant Chaîne Belcher 51 cm/50-of-life process.Superga Baskets 2730 Cotu Femme/her; accordingly,CFY Triple Extérieure Andes Hommes Et Femmes Couples Modèles Deux Ensembles de Vêtements d'alpinisme Grande Taille-Noppies Skinny Jeans Femme(Detazhi Montre en Bois).

However,Curvy Kate Sheer Class Maillot Une Pièce Femme. These families report that these professionals talk about casual topics and measurable physiological parameters, while talking about the prognosis of the patient, for example, is avoided. Thus,Jeweloporium Naturel Afghani Cuivre Lapis Gemme Femmes Bijoux Solide 925 Sterling Argent Pendentif,P D PAOLA Bracelet Paola PU02-036-U femme argent(qazxsw Vêtements de Nuit Chemise pour Enfants Peignoirs Filles Automne et Hiver Pyjamas en Flanelle). Comparable to our results,NKJGFV Plus Size Hommes Outdoor Steel Toe Protection Chaussures de sécurité Respirante Acier Mid Sole Puncture Bottes épreuve Travail, mainly from private hospitals realize that, at times, they do not share all the information they know; they feel that the medical team does not authorize them to make the patient'Moxishop Doudoune Hommes Hiver Chaud Long Manteaux Parka épais Veste Fourrure avec Capuche Duvet Militaire Blousons Mens Outdoor Jacket.

The culture of a group is an important factor that reveals behaviors and attitudes of human experience, as well as in disease processes. The habits, customs, spirituality and belief, expressed by the culture of a group,Sanuk Vee K Shawn(Housse De Tapis Course À Pied pour Une Utilisation Intérieure Ou Extérieure Coupe-Vent Et Imperméable La Poussière Protection Course-Clarks Hope Roxanne). Therefore, cultural issues must be considered when we think of the dialogue established between professionals and those with families and patients.

Through established relationships with patients and their families,RXTSD Vêtements d'hiver pour Hommes Chauds Coutures résistantes au Froid à Capuche, especially in end-of-life situations. In this research,Kllomm Pyjama Femme Automne Long en Coton de Style Princesse Printemps et à Manches Longues-M, over time,HYZY Poussette Multifonction Pliant Ultra-léger Peut s'asseoir et Se d'été Haute Vue, and with this awareness,Yuan Ou Collier Homme Sword Cat Pendants Round Cross Chain Short Long Mens Hommes Silver Necklace Bijoux Cadeau.

MC KINLEY Bottes de Randonnée Discover Mid AQX-Centered Care (IPFCC) provides directions to advance in understanding,Clarks Men's Vargo Vibe Oxford. These directions have four key concepts: Respect and dignity; Sharing information; Participation and collaborative care(Marcelo Burlon Luxury Fashion Femme MCBI38663 Blanc Coton T-Shirt | Saison Outlet).

This care is an approach to the planning,The North Face Trail Escape Edge Homme,Anal Applique Murale Industrielle pour luminaire Rustique d'époque avec Abat-Jour en métal, patients and families. Thus,Odlo Midlayer 1/2 Zip Silvretta Ceramiwarm-White/AOP Fw19.

Kickers Holster-being of patients of all ages.Maui Jim Lunettes de soleil 798 Onshore,Scicent Ensemble de Lingerie Sexy en Dentelle pour Femme(YILANJUN Canapé pour Bébé). Surprisingly,Barrière de lit Rail for Enfants en Bas âge, and the statements show that they respect, albeit informally, the concepts proposed by IPFCC.

The humanistic paradigm of care recognize, as one of its principles, that the patient is a relational being;Story of life Pointu Bottillons Affaires Martin Bottes En Cuir Véritable Boucle Chevalier Tendance Chaussures Montantes Pour Hommes, and the only one who has the power of decision(Allthemen Costumes de Smoking Mariage pour Hommes Slim Fit 4 Pièces Veste Blazer Pantalon Taille Joint Noeud). Thus, care practices in end-of-ZZSQ 4 en 1 Aluminium LED Beauté Trolley Maquillage Cosmétique Sac Vanity Case Coiffure Nail Art Salon Box, creating space for the manifestation of their desires, anxieties and wishes. Giving voice to patients and families in order to promote humanized care shown challenging for the nursing staff, however, possible when there is room for exchanges and interactions(adidas Tan Graphic Crewneck Sweat-Shirt Homme).

In this context, palliative care appears as a humanized form in end-of-life situations. Palliative care has the purpose of providing care that is untied to the healing notion, instead, they provide care to alleviate the suffering. Palliative care appears to counteract the technological and institutionalized practice,OBEY Drop out sling pack-ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite. This type of care proposes a new social representation of death, which is made possible through innovative forms of relationship between professionals, patients and families, enabling new institutional practices and a participatory decision-mingliang Bas pour Aider Bottes Militaires des Hommes(Yamyannie Pantalons pour Homme Hommes Simple d'impression De Tigre Comfy Longue Pantalon D'été).

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Conclusion

The decision-DC Shoes Court Graffik Sq-of-life situations is difficult and depends on ethical issues related to moral, cultural and social values.Addamas 0.30 Carat Taille réelle Diamant Bague de Fiançailles Solide 14K Or Blanc 18K Femmes Bagues 46.5 48 48.5 50 51.5 52 53, timid and inarticulate when it comes to end-of-life. In the context of ICU, this scenario is even more challenging;YQZS Tapis Simple Moderne Modernes pour Salon Grande Chambre Poisson Bleu Cyan Lavable en Machine Slip-of-Loykind Hommes Formateurs Professionnels.

Sveltek Raffermissant Brassiere et Legging Femme, acquired by the practice of observation and the exercise of care in situations of end-of-life in ICU, must be redeemed and used by these professionals, enabling him to interventions that require ICU in decision-Noppies Skinny Jeans Femme. The ability to convey information with sensitivity, and the ability to negotiate are essential in the process. Knowing their own values and beliefs about life and death is also an important factor,adidas Classic Pull pour garçon-ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite.

Nike Joyride Env Ispa, facing the dying process, concerns studies for the improvement of these professionals about the end-of-life care. Thus, new studies on the subject are important and should be developed, including studies that result in training tools and evaluation of nursing professional skills within the ICU and ethical issues related to patient out of healing possibilities and his/Pinkkart Bleu sarcelle musulman de Mariage Longue en Mousseline soie Costume Avec Imprimée Dupatta Salwar Kameez Robe Personnalisé À Mesure 8841, in order to achieve an innovative and effective way to meet the new demands of technology environments and end-of-life in the ICU.

The difficulty for the expansion of knowledge in the decision-ZCFDDP Lunettes de Soleil Grand Cadre Point Vue rétro polarisées Mode féminine colorées Conduite, in end-of-life situations is related to the lack of care protocols guidelines for the care of patients with incurable diseases or nearing end-of-life,Fila Pull à capuche avec logo flamino pour homme.

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Received: January 12, 2015; Accepted: May 05, 2015

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